I just love it when I get the scoop first. Came back from lunch to the message below from my dear one Walt Schmittinger. Not only is Walt the progeny of the late great dean of workers' comp, Jay Schmittinger, he is also always at the cutting edge of the law. For the back story on this issue, refer to my posts of 10/11/11 ("A penny saved..."), 3/17/12 ("Prescriptions Part Two") and 8/28/12 ("The Back to School Post") regarding a carrier's right to force an injured worker to use a preferred vendor for meds. So here is the little gift I found as I returned from lunch today:
"For what it's worth, you're my first email. :-)
The Supreme Court issued its decision in Boone, affirming the Board's authority to order that a claimant source medications from the employer-designated pharmacy source. The decision turns on the Court's interpretation of statutory language. Thus, barring an amendment to the relevant statutes, carriers get to direct pharmacy access in the first instance.
Jury is still out on what happens when the carrier's designated pharmacy provider fails and/or refuses to dispense medications (due to problems with authorization or otherwise)..."
Patricia Boone v. Syab Services, Del. Supr., No. 525, 2012 (July 16,2013).
This is a major victory for carriers although I don't think it will put Injured Workers' Pharmacy and other similar providers out of business. All of those claimants who have appealed all those adverse UR rulings gotta get their drugs from somewhere. As for me, I think I will skip the Vicodin today. Being almost the first to know is its own high. Thank you Walt!
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